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Podcast 162 - Multimodal Pain Management w/ Shane O' Donnell

FOAMfrat Podcast

Release Date: 09/29/2023

Podcast 184 - Diastolic Augmentation w/ Brian Cress show art Podcast 184 - Diastolic Augmentation w/ Brian Cress

FOAMfrat Podcast

In this episode, Tyler Christifulli sits down with cardiac perfusionist Brian Cress to dig into the physiology of coronary perfusion, the mechanics of the intra-aortic balloon pump (IABP), and the clinical finesse of diastolic augmentation. Whether you're just starting to encounter balloon pumps or want to sharpen your transport strategy, this discussion is packed with visual metaphors, waveform analysis, and real-world pearls. 

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Podcast 183 - Cardiac Ultrasound w/ Dr. Weimersheimer show art Podcast 183 - Cardiac Ultrasound w/ Dr. Weimersheimer

FOAMfrat Podcast

In this conversation, Dr. Peter Weimersheimer discusses various techniques and tips for performing cardiac ultrasound in emergency medicine. He emphasizes the importance of understanding probe movements such as sliding, fanning, and rocking to optimize cardiac views. The discussion also covers troubleshooting common challenges in cardiac imaging, the critical role of gel in obtaining clear images, and the transition between different cardiac views. Dr. Weimersheimer emphasizes the importance of identifying cardiac pathologies through ultrasound and shares techniques for obtaining the apical...

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Podcast 182 - AHORA Spanish Stroke Assessment show art Podcast 182 - AHORA Spanish Stroke Assessment

FOAMfrat Podcast

Stroke assessment tools like BEFAST are crucial for swiftly identifying symptoms and expediting treatment. However, language barriers can hinder prompt care for non-English speakers, particularly in the Hispanic community. Developed through a collaborative effort, AHORA adapts the traditional stroke assessment to be culturally and linguistically appropriate for the Spanish-speaking population. Designing Ahora The need for a specific tool became apparent when traditional tools like BEFAST were found to be ineffective for those who did not speak English. After discarding the complex "Rapido,"...

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Podcast 181 - Discrepancies in Testing & Treatment show art Podcast 181 - Discrepancies in Testing & Treatment

FOAMfrat Podcast

Does medicine have dangerous side effects for women? Are the "normal" values we have set for diagnostics possibly endangering specific populations? In this episode of the FOAMfrat podcast, Tyler sits down with Dr.Alyson McGregor, emergency physician and author of Sex Matters, and Tim Redding, EMS educator and lecturer, to discuss the discrepancies in medical testing, diagnosis, and treatment between male and female patients. Dr. McGregor shares her journey of discovering gender bias in medicine, particularly how women’s symptoms are often dismissed or mislabeled as psychiatric in nature....

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Podcast 180 - MCI Collaboration w/ ATCEMS & Travis County Star Flight show art Podcast 180 - MCI Collaboration w/ ATCEMS & Travis County Star Flight

FOAMfrat Podcast

In this episode of the FOAMfrat podcast, join as we discuss mass casualty management with Chief Robert Luckritz of Austin Travis County EMS and Justin Soulier from Travis County Star Flight. Explore the strategies and challenges in mass casualty responses in one of the fastest-growing urban areas in the U.S.

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Podcast 179 - Your First 5 Minutes of an MCI w/ Rommie Duckworth show art Podcast 179 - Your First 5 Minutes of an MCI w/ Rommie Duckworth

FOAMfrat Podcast

Join Rommie Duckworth and FOAMfrat as we discuss the mental framing and big-picture thought process behind the first five minutes of any mass casualty incident (MCI). Rommie Duckworth, a fire captain and shift commander, is a wealth of knowledge on this topic and speaks globally to prepare emergency responders for these events.

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Podcast 178 - ECPR Eligibility and Preparation w/ Alec Wilcox show art Podcast 178 - ECPR Eligibility and Preparation w/ Alec Wilcox

FOAMfrat Podcast

In this episode, Alec Wilcox & I discuss ECPR eligibility & preparation. ECPR, or extracorporeal cardiopulmonary resuscitation, involves taking a patient in cardiac arrest, sucking blood from their venous system, oxygenating it externally, and then pumping it back into their arterial system. This procedure helps maintain blood circulation and oxygen delivery during cardiac arrest, serving as a bridge to further therapy. 

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Podcast 177 - Implementing Ultrasound w/ Allen Wolfe show art Podcast 177 - Implementing Ultrasound w/ Allen Wolfe

FOAMfrat Podcast

The integration of point-of-care ultrasound (POCUS) is transforming emergency medical services (EMS) by enhancing diagnostic capabilities and improving accuracy in answering important clinical questions. Recently, I had the opportunity to discuss this topic extensively with Allen Wolfe, the Senior Director of Education at Life Link III. A significant challenge in incorporating ultrasound technology within EMS has been overcoming initial barriers to adoption. Many programs, burdened by cost concerns and technological intimidation, have historically relegated ultrasound units to the back...

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Podcast 176 - Pediatric TBI Protcol w/ Dr. Banerjee show art Podcast 176 - Pediatric TBI Protcol w/ Dr. Banerjee

FOAMfrat Podcast

In this episode, Dr Banerjee and I discuss a new traumatic brain injury (TBI) protocol his department is trialing for pediatric patients with moderate to severe TBI in collaboration with Arnold Palmer Hospital. This protocol involves administering Keppra and 3% saline in the pre-hospital setting.

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Podcast 175 - The Things We Do w/ PulmCCM show art Podcast 175 - The Things We Do w/ PulmCCM

FOAMfrat Podcast

Matt Hoffman is the editor-in-chief of PulmCCM, a blog that frequently updates its readers on evidence and best practices in critical care medicine. I have always wondered how our work in the field affects a patient's care downstream. Do pulmonologists ever sigh to themselves and think, "God, I wish paramedics would just start/stop doing ____________?" It turns out that this is not the case, but the discussion was super interesting, and I thank Dr. Hoffman for coming to the show.  

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More Episodes
When I became a paramedic, being able to provide pain management was one of the "new interventions" that I looked forward to most. As an EMT, I remember countless times I was without ALS resources and had to watch a patient suffering in pain until we got to the hospital. Trying to obtain any history or perform an assessment on someone writhing in pain can be nearly impossible. As a BLS provider, I would attempt non-pharmacological ways to relieve pain, such as ice packs, warm packs, elevating extremities, and sometimes simply trying to distract them with conversation. While these methods should not be discounted, I will never forget the first time I could provide pain medication to an elderly woman who fell and fractured her hip. I started an IV right there on the floor of the assisted living facility, administered some fentanyl, and comfortably got her to the stretcher. Analgesia did not save this lady's life. Still, it did make her trip to the hospital a little more comfortable and allowed me to obtain an accurate history, including the dizziness and dyspnea she felt before falling.
 
Performing an adequate assessment and obtaining pertinent medical history can be difficult when a patient is experiencing intense pain. For this reason, pain should be managed to a level that allows for comfort & communication. Total pain relief is ideal but may not always be feasible, given hemodynamics and underlying causes.
 
Check out this episode with Tyler & Shane as they discuss multimodal pain management strategies.